Provider Demographics
NPI:1386711042
Name:ALVISO, DEBRA J (DPT, OCS)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:J
Last Name:ALVISO
Suffix:
Gender:F
Credentials:DPT, OCS
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Other - First Name:
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Mailing Address - Street 1:5475 N FRESNO ST
Mailing Address - Street 2:SUITE #110
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8334
Mailing Address - Country:US
Mailing Address - Phone:559-449-0320
Mailing Address - Fax:559-449-0351
Practice Address - Street 1:5475 N FRESNO ST
Practice Address - Street 2:SUITE #110
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8334
Practice Address - Country:US
Practice Address - Phone:559-449-0320
Practice Address - Fax:559-449-0351
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT14222225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA770376866OtherTAX I.D. #